A profile of informal carers in South Africa

by Joubert, Janetta Debora.

Abstract (Summary)

A Profile of Informal Carers in South Africa
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Student:
Supervisor:
Co-supervisor:
Department:
Degree:
Janetta Debora Joubert
Professor J.L. van Tonder
Ms M.H. Pietersen
Sociology
Magister Artium (Demography)
Demographic and epidemiological change has resulted globally in changes in
population and individual health, which, in turn, have resulted in changing care needs.
Demographic change in South Africa, mainly through a confluence of declining fertility
rates and pre-AIDS increases in life expectancy, has produced an ageing population
that is expected to continue ageing for at least the next 10 to 15 years. Currently,
South Africa’s older population (60 years+) has a much higher annual average
percent growth rate than the total population. Having more older persons than ever
before implies increased prevalence of frailty, chronic disease and disability through a
tendency of declining physical, mental and cognitive functional capacities—hence
meaning a larger demand for care.
The changing age structure of a population is commonly associated with changes in
health, disease and cause of death patterns. Recent research indicates an intensive,
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quadruple burden of disease, with the major addition of HIV/AIDS to persistent pretransitional
conditions, non-communicable conditions, and high rates of injuries—
implying an extensive and diverse need for care.
While demographic and epidemiological change have led to an increased demand for
care, health system change, shortages in formal public health care delivery, and the
spiralling costs of private care have led to decreased availability of formal care. Carerequiring
persons therefore may need to rely increasingly on ‘informal care’, defined
here as ‘care provided at home to another person who, because of frailty disability or
ill-health, cannot manage on his/her own’.
Research on informal care in developed nations is well-established and extensive, but
has received very little attention in South Africa where it is not clear how many and
who it is that are informal carers. The thesis study has hence been conducted to
contribute to the limited research in the field of informal care, aiming to establish the
national extent of informal care, and to present a demographic and socio-economic
profile of informal carers.
A multi-stage stratified area cluster probability sample of 2704 persons was drawn
from free-living adults in a nationally-representative household survey in 2000. Field
data were collected during 2611 individual face-to-face interviews. Basic univariate
and logistic regression analyses were conducted.
Of the adult population, 27% were found to be informal carers. Significant prevalence
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differences were found regarding sex, population group, geographic residence,
education, employment status, and income. Adjusting for selected demographic
characteristics, the significance status and levels of some relationships changed.
It is concluded that informal caregiving is widespread in South Africa. While
demographic and epidemiological evidence suggest that the reliance on informal
carers is expected to increase, many informal carers are struggling to shoulder the
physical, mental and financial burden. A national strategy to focus on informal carers
is recommended, to raise awareness about their essential role and value in the health
care system; to recognize their contributions to population and individual health; to
comprehensively support them; and to assess their needs and concerns through
ongoing research.
Key terms
Informal care(r)
Family care(r)
Unpaid care(r)
Home care(r)
South Africa
Demographic transition
Population ageing
Epidemiological transition
Burden of disease
Health transition
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